As part of our focus on operational efficiency in healthcare, we are talking to companies working to streamline clinical and administrative operations for healthcare providers.

Blake Marggraff is the CEO of Epharmix, a remote patient monitoring company that emphasizes research and real-world clinical data to inform its products. Questions about how they can help? Head over to their website and use the “set up a call” button at the top. We aren’t affiliated in any way, but let them know you heard about Epharmix from Health:Further.

Health:Further’s take:

Epharmix caught our attention because of their ruthless focus on data. They have an extensive library of case studies and papers presenting real numbers around the value their patient engagement platform adds. Marggraff said that Epharmix is “research first, sales second.” While that could be just a cheap tagline, we see plenty of evidence it’s the reality for this team. For example, see the section “how does Epharmix drive value?”

In a growing ecosystem filled with shiny objects and new tech, companies that start with data and ask “how does this actually improve patient outcomes and reduce cost or increase efficiency for providers?” will stick around as the rest die off.  


*quotes have been lightly edited for clarity

What is the problem you’re solving?

Epharmix is a care management tool that stratifies rising-risk patients in any one of over two-dozen indications by using patient-reported outcomes and proprietary questions and algorithms. For conditions from diabetes or COPD to postpartum depression or opioid dependence, Epharmix automates certain aspects of patient engagement and collection of patient-report information, allowing provider-based care managers to spend their time working with high-risk patients who need direct intervention. In short, Epharmix helps with clinical prioritization and, therefore, increases clinical efficiency.

 

What is driving the adoption of the Epharmix platform?

Providers are starting to feel that if they can barely handle the financial pressures of a 30 day readmission window, then it’s not enough to just incrementally go to 35, 60, 90 days. They’ve got to look at the management of the rising risk population more globally. But of course, there’s no way humans alone can do that. Run whatever model you want. Even if you have the best luck in the world, you’re still not going to be able to touch all the right people at all the right times and provide the patient care to even justify the cost of the care management team, let alone really bent the cost curve without technology.

 

Talk more about that intersection between technology and human intervention

I think the line is not as clear as people think. Or it’s a little bit more exciting than people think, because most people simplify it to, ‘the humans in a health system work with the tech from a tech company.’ And I think that a giant fallacy. The reality is that tech companies that are succeeding in servicing their partners are wrapping their technology in specific targeted services that are all bespoke: reporting, utilization support, predictive model creation. They’re all tailored to a given partner and that partner is elevated. Specifically, the care managers or whatever element of the clinical side that’s being augmented is elevated to the top of their license.

 

The case in point here is EHRs. It was nobody’s job to use EHRs, and everybody hates them. In the best case, you have a user experience that people don’t actively loath. Whereas it’s really on tech companies – especially those that are supporting transitions of care and chronic care management – to not just make tech easy but to eliminate it altogether.

 

How has that idea influenced Epharmix?

Our customer-partners, especially post-EHR integration, don’t constantly know or see or feel Epharmix’s presence, but they and their patients benefit dramatically from it. Tongue in cheek, paradoxically we win because they barely even know we’re there except that they see material returns very quickly.

 

That’s the tech side, what about the clinical side?

We start with research. Research first, sales second. The upshot of doing research is we wind up with a product that works clinically and operationally for any patient population. It’s not enough to work for 95, 98, 99% of patients. You have to be out there for the decimal places. It pays off. We’re supporting patients with diabetes with an ROI time horizon of at least a year, to people with hypertension – which is longer – to COPD and heart failure – much shorter. It improves how patients are able to manage their conditions and how the payers are having to spend money on comorbidities.

 

How does Epharmix drive value?

For an average rising risk patient population, which is maybe the top 20% of patients, you’ll see an alert rate for patients with diabetes of 1.4% to 1.6%. So less than 2% of the population every day would need a touch, a telephonic intervention, that lasts a couple minutes. Heart failure is a bit higher, around 5%, and as high as 20% for really high-acuity patients. That’s the range, usually 1.4% to 5%. Most care management teams can touch 2% to 5% of the population every day, they just don’t know who to touch.

 

The other thing is ROI. Even for groups that are taking just 10% risk in contracts, we consistently see 3.5x to 5x ROI across a range of disease states and can usually bend that even higher if we’re focusing on conditions that have been difficult for that organization.  We don’t just focus on the same conditions from group to group. We consultatively implement Epharmix to focus on the disease states that are driving the most cost and have the worst performance for a given customer.

 

A really powerful stat here is the average conversation between a care manager and a patient with heart failure. When that patient alerts through Epharmix, the average conversation duration is 241 seconds. Just over four minutes. That’s it. This is not an hour-long deep-dive and it’s definitely not an ED visit. And when you see patient feedback, it’s, ‘this has prevented me from going to the ED and this has held me accountable. This has really helped me get my sugar/breathing/mood under control.’ So the ramifications are sometimes even greater than the care manager might have expected.

 

Let’s look at a COPD patient, who we know is about 60% less likely to be hospitalized than his or her peers. If annual hospitalization for that population is right around 10%, there’s roughly a 1 in 20 chance that Epharmix prevented that person from being hospitalized again for COPD.

 

This sounds great in a value-based world. But we’re still largely living in a fee for service system. So that 60% reduction in hospitalizations is lost revenue, right?

Don’t give us those patients to enroll in Epharmix. Give us the patients for whom you have some kind of risk. Maybe you’re contracted with a self-insured employer, maybe it’s a Medicare Advantage patient, maybe it’s fully capitated patients being managed by a managed care organization. Don’t give us the patients under a big insurer who have glitzy fee-for-service contracts. But, know this: you will need to give us those patients in the next several years. Everything is going that way.

 

Who is your ideal partner?

We work exclusively with health systems and payers at the larger end of the spectrum . We’d love to help everybody but, for example, a private practice isn’t worth the time. To put it more positively, we can’t afford to provide the level of support and service and expertise that we would want to for small entities.

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